"Experienced, Knowledgeable & Personally Committed."
Charles Roberts, PA
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321-638-2002 |
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Worker's Comp FAQ's
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"Experienced, Knowledgeable & Personally Committed." |
Charles Roberts, PA |
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Worker's Comp FAQ's |
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Q: Do I have to pay any of my medical costs? A: No. If you receive a bill from an authorized physician you should send it to your employer's insurance carrier. Your employer must furnish medically necessary remedial treatment, care, and attendance required by the injury. If you were injured on or after 01/01/1994, you must pay a $10 co-payment per visit for treatment after you reach overall maximum medical improvement as determined by your physician.
Q: If my injury causes me to lose time from work, will I be paid for the wages I lose? A: Your employer's insurance carrier is not obligated to pay for the first 7 days of disability you lose from work unless your injury is severe enough that you lose more than 21 days from work. If the injury results in disability and time lost of more than 21 days, a portion of your lost wages (compensation) will be paid from the first day of the disability. You are entitled to compensation from your employer's insurance carrier for time lost from work for days eight through 20.
Q: How much will my benefit check be? A: In most cases, your weekly benefit check will be 66-2/3 percent of your average weekly wage earned during the 91 day period immediately preceding the date of your injury, subject to a state maximum. If you worked less than 90% of the 91 day period immediately preceding your accident, the wages of a similar employee in the same employment who has worked substantially the whole 91 day period will be used in making the determination. Workers' compensation benefits are not taxable. Note: 66-2/3% of your average weekly wage is not the rate at which
all benefits are paid.
Q: When will I get my first check? A: The earliest you can expect your check to be mailed is 14 days after your employer has knowledge of your accident and this can only happen if you report your injury to your employer immediately after the injury occurred. If your employer or your employer's insurance carrier initially deny your right to compensation, a Notice of Denial Form DWC-12 must be filed by your employer (or employer's insurance carrier) with the Division within 14 days after it has knowledge of the injury or death. A copy of the Notice of Denial will be sent to you within 14 days of your employer's knowledge of your accident if your claim is being denied.
Q: What can I do if I am not getting my benefit check? A: Call your employer's insurance carrier first if your check is overdue by more than a week. If you have questions about your claim or do not understand why your benefits have stopped, call the Employee Assistance Office at 1-800-342-1741 and speak to a Workers' Compensation Specialist.
Q: What kinds of medical treatment can I get? A: Medical treatment required as a result of your injury or illness must be provided by a health care provider approved by your employer or your employer's insurance carrier. Chiropractic visits may be limited. Surgery; hospital care; dental; prescription drugs; braces and crutches; and any other medical supplies ordered must be approved by your authorized treating physician.
Q: Can my employer fire me if I am unable to work because of an injury and receiving workers' compensation benefits? A: By law, you cannot be fired for filing or attempting to file a workers' compensation claim. However, the law does not require your employer to hold your position for you until you are able to return to work. Call the Employee Assistance Office at 1-800-342-1741 for details.
Q: If I am unable to return to the type of work I did before I was injured, what can I do? A: Florida Workers' Compensation provides, at no cost to the injured worker, reemployment services to help injured workers return to work. Services include vocational counseling, transferable skills analysis, job seeking skills, job placement, on-the-job training, and formal retraining. To find out more about this program, please contact the Department of Education, Division of Vocational Rehabilitation, Bureau of Rehabilitation and Reemployment Services at (850) 488-3431.
Q: I am not satisfied with the help my attorney is giving me and my employer's insurance carrier will not talk to me. What can I do about it? A: It is important that you maintain a good working relationship with your attorney and that you both communicate openly with each other. You should discuss your problem with your attorney and if necessary, contact the Florida Bar Association at for assistance.
Q: If I am unable to return to work until my doctor releases me, does my employer have to hold my job for me? A: If your employer has more than 50 employees, the law states that your employer is obligated to make available to you, within a 100 mile radius of your residence, work appropriate to your physical limitations within 30 days after the carrier notifies the employer of maximum medical improvement and the employee's physical limitations, or face a penalty. If holding a job open for an injured worker creates a hardship, the employer may either hire a temporary person or hire someone else. The employer may want to contact his legal representative to ensure that he is not in violation of other applicable law, i.e. Family and Medical Leave Act (FMLA), Americans with Disabilities Act (ADA), etc. Employers with 50 or fewer employees are not obligated to rehire injured workers.
Q: Can I choose my own doctor? A: You may choose a physician from a list provided by your employer's insurance carrier or managed care arrangement. If you go to a doctor not authorized by your employer or the insurance carrier, you may be responsible for payment of your medical bills.
Q: When should a claim be reported to the insurance carrier? A: In the event of a medical only or lost time case (where the injured worker loses more than 7 days of work), the employer has 7 calendar days from his knowledge of the injury to submit the First Report of Injury or Illness Form DWC-1 to the insurance carrier. The carrier must submit the First Report of Injury or Illness to the Division on lost time cases within 14 days of the carrier's receipt.
Q: My employer will not report my injury. What can I do? A: Within 7 calendar days after the employer's actual knowledge of the injury, the employer must file the First Report of Injury or Illness Form DWC-1 to the carrier. If the employer refuses to complete the DWC-1, the injured worker should contact the Bureau of Compliance at (850)488-2333 to obtain information about the employer's insurance carrier and then telephone the insurance carrier to report the injury over the telephone. Another option for you would be to call the Employee Assistance Office at 1-800-342-1741. Personnel at this toll-free number will intervene on your behalf.
Q: How long after an accident do I have to report it to my employer? A: An employee who suffers an injury arising out of and in the course of employment shall advise his employer of the injury within 30 days after the date of or initial manifestation of the injury. Failure to so advise the employer shall bar a petition under the workers' compensation law, unless:
Q: What is the time limit for filing a Petition for Benefits? A: Except in certain situations, all injured worker Petitions for Benefits must be filed within two years of the date of injury or death. For dates of accident on or after 01/01/1994, if there is payment of any indemnity benefit or furnishing of remedial treatment, the limitation period to file the Petition for Benefits is one year from such payment or treatment.
Q: How long can I receive temporary total disability benefits? A: In cases where the injured worker can do no work whatsoever for a temporary time period, 66-2/3 percent of his average weekly wage will be paid for a period not to exceed 104 weeks for dates of accident occurring on or after 01/01/1994.
Q: Can I receive social security benefits and workers' compensation benefits at the same time? A: If you were injured before 01/01/1994 and you are receiving wage loss benefits and regular social security retirement benefits, your social security retirement benefits are primary. The total amount of your wage loss benefits and the social security benefits cannot exceed the amount of wage loss benefits which would otherwise be payable. Combined benefits cannot exceed 66-2/3 percent of the employee's average weekly wage.
Q: Can I receive unemployment compensation and workers' compensation benefits at the same time? A: Workers' compensation benefits will not be payable for temporary total disability for any week in which the injured worker has received unemployment compensation. You must be medically unable to work to receive temporary total disability benefits. To receive unemployment compensation, you must be available and able to work. If the injured worker is entitled to temporary partial benefits, unemployment compensation could be due and would serve as the primary compensation. Additionally, the sum of the two benefits may not exceed the amount of the temporary partial benefits for which the injured worker is entitled.
Q: Can I receive a settlement of my medical and indemnity benefits? A: Settlements are not automatic in the state of Florida. The injured worker may have complete settlement/washout of medical and indemnity benefits. Settlement shall be allowed at any time in any case in which the employer or carrier has filed a written Notice of Denial Form DWC-12 within 120 days after the date of injury, and the judge of compensation claims finds a justiciable controversy as to legal or medical compensability of the claimed injury or the alleged accident. A Notice of Denial Form DWC-12 is not required for a washout under section 440.20(11)(b), Florida Statutes. The statute applies to all claims where the "Parties have not previously settled, regardless of the date of accident."
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Copyright © 2002-2003 Intellisys. All rights reserved. |
Copyright © 2002-2003 Intellisys. All rights reserved.
